Anatomical path of the tension-free vaginal tape: Reassessing current teachings

Rahn, David D.; Marinis, Spyridon I.; Schaffer, Joseph I.; Corton, Marlene M.

doi:10.1016/j.ajog.2006.07.009

Cited by 6 publications

(4 citation statements)

References 10 publications

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“…The path of retropubic midurethral sling placement lies in close proximity with clitoral neuroanatomy [2,10–13]. Different scenarios for nerve injury associated with retropubic sling placement are possible.…”

Section: Discussionmentioning

confidence: 99%

“…After exiting Alcock's canal medial to the ischial tuberosity, the DNC travels caudal to the perineal membrane for most of its path [2,11]. The retropubic sling trochar needle passes cephalad to the perineal membrane [13], making DNC transection injury unlikely. However, a plausible mechanism of DNC injury involves compression of the nerve against the ischiopubic ramus by vaginal sidewall retractors during surgery [11].…”

Section: Discussionmentioning

confidence: 99%

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Clitoral Pain Following Retropubic Midurethral Sling Placement

2015

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IntroductionAlthough uncommon, postprocedural pain with associated sexual dysfunction may be seen in patients after retropubic midurethral sling placement for treatment of stress urinary incontinence.AimsTo describe a report of a woman who developed localized severe, persistent periclitoral pain after placement of a retropubic midurethral sling.MethodsA healthy 41‐year‐old underwent an uncomplicated retropubic midurethral sling procedure. She developed persistent postoperative clitoral pain with worsening associated with arousal, impairing sexual function. Symptoms resolved with time and a course of steroid medication.Main Outcome MeasuresTo report a case of clitoral pain following midurethral sling surgery, and to provide a discussion about clitoral innervation, possible pain etiologies, and management options.ResultsWe report a case of clitoral pain associated with sexual dysfunction and provide a review of clitoral innervation as well as potential mechanisms of nerve injury associated with a retropubic sling procedure.ConclusionClitoral pain symptoms following placement of a retropubic midurethral sling should be evaluated and promptly addressed, given the potential negative impact on the patient's sexual function. Christofferson M, Barnard J, and Montoya TI. Clitoral pain following retropubic midurethral sling placement. Sex Med 2015;3:346–348.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clitoral Pain Following Retropubic Midurethral Sling Placement

2015

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“…Surgical management of stress incontinence has undergone major changes over the last decade with the introduction of the TVT, and now the transobturator procedures. The TVT procedure has become one of the most commonly performed surgical procedures for stress incontinence worldwide [4,5]. Success rates for this procedure are high, ranging from 72-97% [6], and dry rates of up to 81% with up to 7.6 years follow-up.…”

Section: Discussionmentioning

confidence: 99%

Lynx® midurethral sling system: a 1-year prospective study on efficacy and safety

2008

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The objective of this study is to determine the outcomes for the Lynx midurethral sling system in the treatment of urodynamic stress incontinence (USI). Prospective study of 118 subjects who underwent a Lynx midurethral sling procedure for USI. Subjects were considered cured if they were subjectively dry by history and objectively dry by standing stress test. Intraoperative and postoperative complications were documented. Complete information was available on 102 (86%) subjects at 1 year. Ninety-two patients were considered cured, and ten were failures. There were four intraoperative bladder perforations and five (4.2%) erosions. Two patients developed urinary retention with one resolving at 31 days and the other undergoing subsequent takedown at 6 months. Both remain dry at 12 months. The Lynx midurethral sling system shows high subjective and objective success rates for the treatment of USI at 1 year with low rates of intraoperative and postoperative complications.

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“…These events are directly related to the introduction of the guiding needle and its peculiar course along the mentioned anatomical structures and through the retropubic space. However, not all the cases of atypical course of the needle or misplacement of the mesh become symptomatic [4].…”

Section: Introductionmentioning

confidence: 99%

Mesh erosions after transobturator suburethral tape: a case series

Cipullo

Fasolino

et al. 2008

Gynecol Surg

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The transobturator tape (TOT) is a widely used minimally invasive procedure for the treatment of stress urinary incontinence (SUI). Despite the reported low rate of intraoperative adverse events after TOT, many cases of delayed vaginal erosion were published and are cause of great concern. We reviewed our experience with the TOT procedure using Uratape® (Mentor-Porges, Le Plessis Robinson, France), a non-woven, non-elastic polypropylene tape. In our series of 102 patients treated with TOT for SUI, we noted three cases of delayed vaginal wall erosion (2.9%). All patients were treated with excision of the eroded portion of the tape. Other reports have shown, in some cases, a considerably higher rate of erosion after TOT using the same mesh. Further investigation is needed to evaluate prospectively the relationship between the type of mesh used for surgery and erosions, and the possible aetiological role of other concomitant factors.

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Anatomical path of the tension-free vaginal tape: Reassessing current teachings

Cited by 6 publications

References 10 publications

Clitoral Pain Following Retropubic Midurethral Sling Placement

Clitoral Pain Following Retropubic Midurethral Sling Placement

Lynx® midurethral sling system: a 1-year prospective study on efficacy and safety

Mesh erosions after transobturator suburethral tape: a case series

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